YAKHAK HOEJI (약학회지)

The Pharmaceutical Society of Korea (대한약학회)
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Ribavirin and Interferon Treatment for MERS-CoV Infection: A Clinical Literature Review

메르스 감염에서 리바비린과 인터페론 사용에 대한 임상 문헌 고찰

  • Received : 2015.08.01
  • Accepted : 2015.11.09
  • Published : 2015.12.31
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Abstract

Middle East respiratory syndrome - coronavirus infection has posed substantial threat to public health with extremely high mortality rate in 2015. Although there are no approved novel medications for coronavirus, several antiviral agents such as ribavirin and interferon have been tried to MERS patients according to the in-vitro inhibitory effect, therapeutic effect on the animal model and experience from the severe acute respiratory syndrome - coronavirus infection. The aim of this study is to evaluate the clinical evidence of the antiviral treatment for MERS-CoV infection. After systematically searching the medical literature databases, I found five studies described the clinical efficacy of antiviral treatment on MERS patients. All of them were about the combination therapy of ribavirin and interferon (IFN). Two of them were retrospective cohort studies with quality of evidence (QOE) II and the others were observational study and case reports with QOE III. As a result of critical appraisal, it is concluded that none of those studies represented confirmatory clinical evidence of the efficacy of ribavirin and interferon combination therapy on MERS patients. Although Omrani et al. represented that ribavirin and IFN treatment had significantly improved survival at 14 days, it was not enough time to conclude the effect.

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References

  1. Al-Tawfiq, J. A., Zumla, A., Gautret, P., Gray, G. C., Hui, D.S., Al-Rabeeah, A. A. and Memish, Z. A. : Surveillance for emerging respiratory viruses. Lancet Infect. Dis. 14, 992 (2014). https://doi.org/10.1016/S1473-3099(14)70840-0
  2. Assiri, A., McGeer, A., Perl, T. M., Price, C. S., Al Rabeeah, A. A., Cummings, D. A., Alabdullatif, Z. N., Assad, M., Almulhim, A., Makhdoom, H., Madani, H., Alhakeem, R., Al-Tawfiq, J. A., Cotton, M., Watson, S. J., Kellam, P., Zumla, A. I. and Memish, Z. A. : KSA MERS-CoV Investigation Team.: Hospital outbreak of Middle East respiratory syndrome coronavirus. N. Engl. J. Med. 369, 407 (2013). https://doi.org/10.1056/NEJMoa1306742
  3. Assiri, A., Al-Tawfiq, J. A., Al-Rabeeah, A. A., Al-Rabiah, F. A., Al-Hajjar, S., Al-Barrak, A., Flemban, H., Al-Nassir, W. N., Balkhy, H. H., Al-Hakeem, R. F., Makhdoom, H. Q., Zumla, A. I. and Memish, Z. A. : Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect. Dis. 13, 752 (2013). https://doi.org/10.1016/S1473-3099(13)70204-4
  4. Memish, Z. A., Al-Tawfiq, J. A., Assiri, A., AlRabiah, F. A., Al Hajjar, S., Albarrak, A., Flemban, H., Alhakeem, R. F., Makhdoom, H. Q., Alsubaie, S. and Al-Rabeeah, A. A. : Middle East respiratory syndrome coronavirus disease in children. Pediatr. Infect. Dis. J. 33, 904 (2014). https://doi.org/10.1097/INF.0000000000000325
  5. Zumla, A., Memish, Z. A., Maeurer, M., Bates, M., Mwaba, P., Al-Tawfiq, J. A., Denning, D. W., Hayden, F. G. and Hui, D. S. : Emerging novel and antimicrobial-resistant respiratory tract infections: new drug development and therapeutic options. Lancet Infect. Dis. 14, 1136 (2014). https://doi.org/10.1016/S1473-3099(14)70828-X
  6. Coleman, C. M. and Frieman, M. B. : Treating MERS-CoV during an outbreak. Lancet Infect. Dis. 14, 1030 (2014). https://doi.org/10.1016/S1473-3099(14)70939-9
  7. Momattin, H., Mohammed, K., Zumla, A., Memish, Z. A. and Al-Tawfiq, J. A. : Therapeutic options for Middle East respiratory syndrome coronavirus (MERS-CoV)--possible lessons from a systematic review of SARS-CoV therapy. Int. J. Infect. Dis. 17, e792 (2013). https://doi.org/10.1016/j.ijid.2013.07.002
  8. 대한감염학회/대한화학요법학회: MERS 항바이러스제 치료지침, version 1.1. Available at http://www.ksid.or.kr/mail/file/ MERS02.pdf (accessed on July 27, 2015).
  9. U.S. Preventive Services Task Force: Guide to clinical preventive services: report of the U.S. Preventive Services Task Force 1st ed., DIANE Publ. Co., Pennsylvania, p. 263 (1989).
  10. Shalhoub, S., Farahat, F., Al-Jiffri, A., Simhairi, R., Shamma, O., Siddiqi, N. and Mushtaq, A. : IFN-${\alpha}2a$ or IFN-${\beta}1a$ in combination with ribavirin to treat Middle East respiratory syndrome coronavirus pneumonia: a retrospective study. J. Antimicrob. Chemother. 70, 2129 (2015). https://doi.org/10.1093/jac/dkv085
  11. Omrani, A. S., Saad, M. M., Baig, K., Bahloul, A., Abdul-Matin, M., Alaidaroos, A. Y., Almakhlafi, G. A., Albarrak, M. M., Memish, Z. A. and Albarrak, A. M. : Ribavirin and interferon alfa-2a for severe Middle East respiratory syndrome coronavirus infection: a retrospective cohort study. Lancet Infect. Dis. 14, 1090 (2014). https://doi.org/10.1016/S1473-3099(14)70920-X
  12. Al-Tawfiq, J. A., Momattin, H., Dib, J. and Memish, Z. A. : Ribavirin and interferon therapy in patients infected with the Middle East respiratory syndrome coronavirus: an observational study. Int. J. Infect. Dis. 20, 42 (2014). https://doi.org/10.1016/j.ijid.2013.12.003
  13. Khalid, M., Al Rabiah, F., Khan, B., Al Mobeireek, A., Butt, T. S. and Al Mutairy, E. : Ribavirin and interferon-${\alpha}2b$ as primary and preventive treatment for Middle East respiratory syndrome coronavirus: a preliminary report of two cases. Antivir. Ther. 20, 87 (2015).
  14. Khalid, M., Khan, B., Al Rabiah, F., Alismaili, R., Saleemi, S., Rehan-Khaliq, A. M., Weheba, I., Al Abdely, H., Halim, M., Nadri, Q. J., Al Dalaan, A. M., Zeitouni, M., Butt, T, and Al Mutairy, E. : Middle Eastern Respiratory Syndrome Corona Virus (MERS CoV): case reports from a tertiary care hospital in Saudi Arabia. Ann. Saudi. Med. 34, 396 (2014). https://doi.org/10.5144/0256-4947.2014.396
  15. European Centre for Disease Prevention and Control. Epidemiological update: Middle East respiratory syndrome coronavirus (MERS-CoV) Available at http://ecdc.europa.eu/en/press/news/Pages/News.aspx (accessed on September 2, 2015).
  16. Korea Centers for Disease Control and Prevention. Middle East respiratory syndrome information. Available at http://www.mers.go.kr/mers/html/jsp/main.jsp (accessed on September 2, 2015).
  17. 최재욱, 김경희, 조용민, 김상후 : 한국 메르스 감염의 역학현황과 공중보건학적 대응조치 방향. 대한의사협회지 58, 487 (2015).
  18. de Wilde, A. H., Jochmans, D., Posthuma, C. C., Zevenhoven-Dobbe, J. C., van Nieuwkoop, S., Bestebroer, T. M., van den Hoogen, B. G., Neyts, J. and Snijder, E. J. : Screening of an FDA-approved compound library identifies four smallmolecule inhibitors of Middle East respiratory syndrome coronavirus replication in cell culture. Antimicrob. Agents Chemother. 58, 4875 (2014). https://doi.org/10.1128/AAC.03011-14
  19. Falzarano, D., de Wit, E., Martellaro, C., Callison, J., Munster, V. J. and Feldmann, H. : Inhibition of novel ${\beta}$ coronavirus replication by a combination of interferon-${\alpha}2b $and ribavirin. Sci. Rep. 3, 1686 (2013). https://doi.org/10.1038/srep01686
  20. Falzarano, D., de Wit, E., Rasmussen, A. L., Feldmann, F., Okumura, A., Scott, D. P., Brining, D., Bushmaker, T., Martellaro, C., Baseler, L., Benecke, A. G., Katze, M. G., Munster, V. J. and Feldmann, H. : Treatment with interferon-${\alpha2b}$ and ribavirin improves outcome in MERS-CoV-infected rhesus macaques. Nat. Med. 19, 1313 (2013). https://doi.org/10.1038/nm.3362
  21. Stockman, L. J., Bellamy, R. and Garner, P. : SARS: systematic review of treatment effects. PLoS Med. 3, e343 (2006). https://doi.org/10.1371/journal.pmed.0030343
  22. Centers for Disease Control and Prevention. Severe Acute Respiratory Syndrome (SARS). Available at http://www.cdc.gov/sars/ (accessed on July 27, 2015).
  23. de Wilde, A. H., Raj, V. S., Oudshoorn, D., Bestebroer, T. M., van Nieuwkoop, S., Limpens, R. W., Posthuma, C. C., van der Meer, Y., Barcena, M. and Haagmans, B. L., Snijder, E. J. and van den Hoogen, B. G. : MERS-coronavirus replication induces severe in vitro cytopathology and is strongly inhibited by cyclosporin A or interferon-? treatment. J. Gen. Virol. 94, 1749 (2013). https://doi.org/10.1099/vir.0.052910-0
  24. Hart, B. J., Dyall, J., Postnikova, E., Zhou, H., Kindrachuk, J., Johnson, R. F., Olinger, G. G. Jr., Frieman, M. B., Holbrook, M. R., Jahrling, P. B. and Hensley, L. : Interferon-${\beta}$ and mycophenolic acid are potent inhibitors of Middle East respiratory syndrome coronavirus in cell-based assays. J. Gen. Virol. 95, 571 (2015).
  25. Chan, J. F., Yao, Y., Yeung, M. L., Deng, W., Bao, L., Jia, L., Li, F., Xiao, C., Gao, H., Yu, P., Cai, J. P., Chu, H., Zhou, J., Chen, H., Qin, C. and Yuen, K. Y. : Treatment with lopinavir/ritonavir or interferon-${\beta}1b $improves outcome of MERS-CoV infection in a non-human primate model of common marmoset. J. Infect. Dis. in press (2015).
  26. To, K. K., Hung, I. F., Chan, J. F. and Yuen, K. Y. : From SARS coronavirus to novel animal and human coronaviruses. J. Thorac. Dis. 5, S103 (2013).
  27. Zumla, A., Hui, D. S. and Perlman, S. : Middle East respiratory syndrome. Lancet. doi:10.1016/S0140-6736(15)60454-8 (2015).